Exam 3, arrhythmias and heart block blonder

Question 1

What is an AV block

Answer 1

delay or interruption in transmission of an impulse from the atria to the ventricles due to anatmoic or functional impairment in conduction system

Question 2

What are major causes of AV blocks

Answer 2

increased vagal tone
fibrosis and sclerosis of conduction system
IHD
Cardiomyopathy and myocarditis
Congenital Heart disease
Familial AV block

Question 3

majority of AV blocks are due to what

Answer 3

fibrosis and sclerosis of conduction system

Question 4

second most common cause of AV blocks is what

Answer 4

Ischemica heart disease

Question 5

What drugs can induce AV blocks

Answer 5

digitalis
CCB (non DHP)
beta blockers
amiodarone
adenosine

Question 6

What surgeries can casue AV blocks

Answer 6

cardiac surgery
catheter ablation of arrhythmias
transcatheter VSD closure
alcohol septal ablation for HOCM
TAVr(transcatheter AV replacement)

Question 7

What characterizing a first degree AV block on EKG

Answer 7

PR interval >.20 milliseconds

1 large box

Question 8

What are the types of second degree AV block are there

Answer 8

Mobitz I, Wenckebach

Mobitz II,

Question 9

What is a 3rd degree AV block

Answer 9

no atrial impulses reach ventricle in 3rd degree AVB

Question 10

what is difference with HR in AV block and dissociation

Answer 10

block HR is slow

dissociation is VTach

Question 11

What is the most common cardiac arrhythmia

Answer 11

Afib

Question 12

What is bpm of AFib

Answer 12

300-600 bpm

Question 13

how does AFib change CO

Answer 13

decreases filling from increased rate encroaching on diastolic filling time

Question 14

What are the main risk factors for Afib

Answer 14

HTN heart disease
CHD
RF in underdeveloped countries

Question 15

What is paroxysmal afib

Answer 15

AF that terminates spontaneously or with intervention within 7 days of onset
may recur with variable frequency

Question 16

What is persistent Afib

Answer 16

fails to self terminate within 7 days

pharmacologic or electrical cardioversion usually required to restore Normal Sinus Rhythm (NSR)

Question 17

What is Long Standing persistent Afib

Answer 17

AFib that has lasted for more than 12 months

Question 18

What is permanent Afib

Answer 18

persistent Afib where a joint decision has been made by the patient and clinicion to no longer pursue a rhythm control strategy

Question 19

What group is considered low risk of AFib

Answer 19

“lone” Afib
15-30%
younger males
frequently familial, low risk of thrombo-embolus

Question 20

What is recurrent Afib

Answer 20

90% afib patients have asymptomatic recurrent episodes lasting up to 48 hours

Question 21

What is subclinical Afib

Answer 21

Afib detected in asymptomatic patients without a prior Dx. Many of these pateints have paroxysmal Afib

Question 22

What are symptoms of Afib

Answer 22

palpitations, syncope, dyspnea, fatigue

Question 23

What are preciptating causes of Afib

Answer 23

exercise, emotion, alcohol, holiday heart syndrome

Question 24

What would you find on PE of Afib

Answer 24

mitral valve disease, especially MS, CHF findings

Question 25

What are the two methods for Tx o f Afib

Answer 25

Rate control via AV blockers

Rhythym control- anti coagulate and resrote NSRhythym by meds or electrical cardioversion

Question 26

What is Criteria for Afib risk

Answer 26

CHA2DS2VASc
CHF
HTN
Age >75, 2points
Diabetes
Stroke (2x)
Total possible 9 points
all 9= 15%/year

Question 27

What is a bad sign for PVCs

Answer 27

syncope

Question 28

Are PVCs a huge concern

Answer 28

no not really. not in healthy individuals

Question 29

How concerned should you be if you seen PVCs in a patient with Acute Coronary Syndromes

Answer 29

bad prognostic sign

Question 30

What determines prognosis of PVCs

Answer 30

severity of LV function

Question 31

what is a unique symptom of PVC

Answer 31

Pressure R make them feel like they want to cough